纳米碳在达芬奇机器人直肠癌根治术中的应用
Application of Carbon Nanoparticles in Da Vinci Radical Resection of Rectal Carcinoma
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摘要:目的 总结纳米碳示踪剂在达芬奇机器人直肠癌根治术的使用体会。方法 收集分析2017年7月—2017年12月经达芬奇机器人直肠癌根治术中应用纳米碳示踪剂完成的11例患者临床资料。结果 全部11例手术均在机器人辅助下完成, 无中转开腹, 3例行回肠保护性造口。手术时间(184.6±23.5)min, 术中出血(30.9±7.6)ml。切除肠管长度(18.8±2.1)cm, 淋巴结清扫数目(17.5±1.9)枚, 阳性(3.4±1.5)枚, 其中微小淋巴结(7.5±1.4)枚。下切缘距肿瘤(2.8±0.4)cm, 手术标本两断端及环周切缘未见癌, 均符合全直肠系膜切除标准。术后肛门或造口排气时间(25.9±7.4)h, 恢复进食时间(12.7±3.1)h, 术后住院时间(6.6±0.7)d。未出现出血、感染、肠瘘或肠梗阻等并发症, 术后随访1~6月暂未发现复发或转移。结论 在达芬奇机器人直肠癌根治术中使用纳米碳示踪剂简便安全, 有利于淋巴结清扫, 特别是微小淋巴结的清扫。Abstract:Objective To summarize the application of carbon nanoparticles in Da Vinci radical resection of rectal carcinoma.Methods We collected and analyzed the clinical data of 11 rectal cancer patients who underwent Da Vinci total mesorectal excision(TME) with carbon nanoparticles injection before operation in our hospital from July 2017 to December 2017.Results All operations went smoothly without abdominal incision, and three of them received ileostomy.The operation time was (184.6±23.5)ml, the amount of bleeding was (30.9±7.6)ml, and the length of removal intestinal canal was (18.8±2.1)cm.The number of dissected lymph node was (17.5±1.9), among them there were (3.4±1.5) of lymphatic metastasis and (7.5±1.4) of tiny lymph node.The length of lower incisal margin was (2.8±0.4)cm.There was no tumor tissue in broken end or circumferential resection margin of specimens, all were conformed to total mesorectal excision.The exhaust time was (25.9±7.4)h, the fasting time was (12.7±3.1)h and the length of stay after operation was (6.6±0.7)d.There was no bleeding, infection, intestinal fistula or intestinal obstruction.There was no relapse or metastasis in 1-6 months of follow-up.Conclusion Carbon nanoparticles are safe and convenient in Da Vinci total mesorectal excision, and they are helpful for lymphadenectomy especially to tiny lymph node.
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